Title of the article: Sex hormones and psychopathology in Drug naïve Schizophrenia

Abstract Association of Prolactin levels & symptoms in first episode drug naive Schizophrenia have been equivocal. This cross-sectional comparative study in a tertiary setting was conceived to examine the role of Sex hormones and symptoms in first episode untreated schizophrenia. To measure & compare the circulating estradiol, testosterone & prolactin levels in drug naive first episode patients with Schizophrenia & healthy age matched controls. To test the association between stress, illness and psychopathology with hormone levels.In a cross-sectional Comparative study 102 subjects (Patients vs Healthy Controls)were enrolled. First episode drug naive patients (N = 51)with International Classification of Diseases-10 (ICD-10) diagnosis of Schizophrenia were recruited by consecutive sampling. Symptom severity was measured using Positive and Negative Symptom Scale (PANSS).Sex hormone estimation was done at baseline using radioimmunoassay method (RIA) prior to antipsychotic initiation. 51 healthy controls were recruited to participate in the study. Mildly elevated prolactin levels were associated with higher total PANSS scores in women. Hallucinatory behavior and Grandiosity are positively correlated in patients with raised prolactin levels at baseline. Testosterone and estradiol were not associated with psychopathology. Women perceived more stress than men. Elevated prolactin levels in drug naive Schizophrenia can be a putative marker for predicting gender differences in symptom severity and treatment responses in future.